BWFE2017-004378-495 CALLE TAMPICO
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LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BWFE2017-0043
Property Address:
81925 FOUR SEASONS PIL
APN:'
767860003
Application Description:
LA QUINTA HOUSING 1 LLC/BLOCK WALL
Property Zoning: ,
Application Valuation:
$4,875.00
Applicant:
WOODBRIDGE PACIFIC GROUP LLC
27271 LAS RAMBLAS SUITE #100
MISSION VIEJO, CA 92691
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
{commencing with Section 7000) of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: B License No.: 963887
Date= 3�x }Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any
structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that he
or she did not build or improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors' State License Law.).
(_) I am exempt under Sec. : B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/9/201
Owner: ® w
LA QUINTA HOUSING 1 LLC �
27271 LAS RAMBLAS STE 1
MISSION VIEJO, CA 92691 ® r� o
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Contractor: a cr � pLLI
WOODBRIDGfl PACIFIC GRO • C o
27271 LAS RAMBLAS SUITE #100 U o
MISSION VIbID, CA 92691
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(949)348-81629
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Llc. No.: 963887 M
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section T700 of the Labor Code, for the performance
of t e ork for which this permit is issued.
M4 f ave and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the periormance of the work for which this permit is
issued. My workers' compensation insurance carrier and polity number are:
Carrier: GRANITE STATE INSURANCE COMP>NY Policy Number: WC065256310
_ I certify that in the performance )f the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agreeRhat, if I should become subject to the
workers' compensation provisions of Sectirn 3700 of the Labor Code, I shall forthwith
comply with those provisions.
77
Date�./'�L./% Applicant:
WARNING: FAILURE TO SECURE WORKERS' ZOMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10(2,000). IN -ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED =0R IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the. Building Official for a permit subject to
the conditions and restrictions set forth on :his application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit issued
as a result of this application , the owner, aid the applicant, each agrees to, and shall
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related b the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this ap:olication becomes null and void if work is not
commenced within 180 days from date of issuance of such permit, or cessation of work
for 180 days will subject permit to cancella-ion.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon•the ab ve-
mentioned property for inspection purpos6.
Date:Signature (Applicant or Agent): _ —
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Date: 3/9/2017
Application Number: BWFE2017-0043
Owner:
Property Address: 81925 FOUR SEASONS PL
LA QUINTA HCUSING 1 LLC
APN: 767860003
27271 LAS RAMBLAS STE 100
Application Description: LA QUINTA HOUSING 1 LLC/BLOCK WALL
MISSION VIEJC, CA 92691
Property Zoning:
Application Valuation: .$4,875.00
Applicant:
Contractor:
WOODBRIDGE PACIFIC GROUP LLC
WOODBRIDGE*PACIFIC GROUP LLC
27271 LAS RAMBLAS SUITE #100
272711AS RAMBLAS SUITE #100
MISSION VIEJO, CA 92691
MISSION VIEJC., CA 92691
(949)348-8162
--------------------------------------------------------------------------------------------
Llc. No.: 963887
Detail: 75LF OF 6' GARDEN WALL AT WEST PROPERTY LINE, [PROTO II WALL SYSTEM] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO;
PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2016 CALIFORNIA BUILDING CODES.
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DESCRIPTION
FINANCIAL INFORMATION,
ACCOUNT QTY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404 0
$50.67
DESCRIPTION
ACCOUNT QTY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600 0
$63.33
Total Paid for BLOCK WALL:
$114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS 561473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
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